糖尿病视网膜病变的风险预测模型:系统审查
Hui Huang1, Yingmin Wu1, Hejiang Ye2
1School of Management, Chengdu University of Traditional Chinese Medicine, Wenjiang, Chengdu, Sichuan, China.
Frontiers in endocrinology
|July 28, 2025
概括
糖尿病视网膜病变的预测模型显示出不同的性能,但存在高偏差风险. 未来的研究应该专注于透明的模型构建和外部验证,以更好地临床使用.
科学领域:
- 眼科医生 眼科 眼科
- 内分泌学 在内分泌学.
- 生物统计学 生物统计学
背景情况:
- 糖尿病视网膜病变是糖尿病的一种严重并发症,对公众健康构成越来越大的挑战.
- 预测模型对于早期识别高风险患者至关重要,使及时干预成为可能.
研究的目的:
- 系统地评估糖尿病视网膜病变的现有预测模型.
- 确定临床应用的卓越模型,并指导未来的模型开发.
主要方法:
- 在主要数据库 (PubMed,科学网,Embase,Cochrane图书馆) 进行了全面的文献搜索,截至2023年11月14日.
- 使用PROBAST工具评估了包含的模型的偏差风险和适用性.
主要成果:
- 纳入了15项关于糖尿病视网膜病变预测模型的研究,模型性能 (曲线下的区域) 从0.700到0.960.
- 所有15个模型都表现出高偏差风险,尽管5个模型表现出更好的适用性.
- 常见的预测因素包括糖尿病持续时间,年龄,HbA1c,血清肌素和尿液中白素与肌素的比率.
结论:
- 尽管有一些预测能力,但目前糖尿病视网膜病变模型中偏差的高风险令人担忧.
- 未来的研究需要优先考虑透明度,大规模机器学习和多中心外部验证.
- 这一系统性审查已在PROSPERO (CRD42023483749) 中注册.
相关概念视频
Type II Diabetes Mellitus III: Clinical Manifestations and Diagnosis
17
Type 2 diabetes mellitus develops gradually and is often asymptomatic in early stages.Clinical ManifestationsWhen symptoms appear, they include fatigue, blurred vision, pruritus, delayed wound healing, and recurrent infections, particularly candidal infections. Peripheral neuropathy may present as numbness or tingling in the extremities. Classic hyperglycemia symptoms—polyuria, polydipsia, and polyphagia—are less common. Most patients are overweight and frequently have associated...
17
Diabetic Retinopathy
55
DefinitionDiabetic retinopathy is a microvascular complication of diabetes affecting the retinal blood vessels.Risk FactorsDiabetic retinopathy is present in almost all individuals with type 1 diabetes and more than 60% of those with type 2 diabetes after two decades of disease.The risk increases with poor glycemic control, hypertension, dyslipidemia, smoking, pregnancy, and puberty.Although cataracts and glaucoma are also more frequent in people with diabetes, retinopathy remains the leading...
55
Diabetic Nephropathy
32
Definition Diabetic nephropathy is a chronic kidney complication that results from prolonged hyperglycemia.Prevalence It is the most common cause of chronic kidney disease (CKD) and end-stage renal disease (ESRD) worldwide, affecting up to half of individuals with diabetes.Pathophysiology • Sustained hyperglycemia triggers multiple hemodynamic and metabolic changes in the kidney. • Early in the disease, increased renal blood flow and glomerular hyperfiltration...
32


